Practical aspects of insulin pen devices

Abstract

Insulin pen devices have several advantages over the traditional vial-and-syringe method of insulin delivery, including improved patient satisfaction and adherence, greater ease of use, superior accuracy for delivering small doses of insulin, greater social acceptability, and less reported injection pain. In recent years, pens have become increasingly user-friendly, and some models are highly intuitive to use, requiring little or no instruction. Despite this progress, uptake of these devices in the United States has not matched that in many other areas of the world. There is a need for improved awareness of the current characteristics of insulin pen devices among United States health care professionals. Knowledge of the design improvements that have been incorporated into pens, both to address patient needs and as a result of the improved technology behind the device mechanics, is essential to promoting the use of insulin pen devices. This review highlights some of the practical aspects of pen use and discusses the factors to be considered when selecting among different insulin pens.

Figure 1.

The five steps of insulin pen use.^a This is performed by instructing the patient to dial up 2 units and to inject these units into the air. ^b The button needs to be pressed and the needle held in the skin for 5–10 seconds to ensure complete delivery of insulin dose. The easiest way to ensure this is to instruct the patient to count to 5 (or 10, if using the SoloSTAR^®) before removing the needle.